Chae Hyunwoo, Jun Kwanghee, Lee Ju-Yeun
College of Pharmacy, Seoul National University, Seoul, Republic of Korea.
College of Pharmacy, Research Institute of Pharmaceutical Science, Gyeongsang National University, Jinju, 52828, Republic of Korea.
Sci Rep. 2025 Jul 2;15(1):22580. doi: 10.1038/s41598-025-07197-x.
The increasing prevalence of chronic respiratory diseases among older adults significantly affects morbidity and mortality rates. Hospitalizations from exacerbations and acute respiratory infections (ARIs) pose a substantial burden on healthcare systems. This study aimed to estimate the nationwide incidence of such hospitalizations among older adults with chronic respiratory diseases, identify risk factors, and assess outcomes like intensive care needs and mortality. Utilizing data from the National Health Insurance Service senior cohort (2016-2017), we analyzed patients aged 60 and above diagnosed with chronic obstructive pulmonary disease, asthma, or bronchiectasis. We followed hospitalization rates over two years, employing Cox regression models to identify predictors for hospitalizations. Out of 117,793 patients, 16,024 (13.6%) patients had overlapping respiratory diseases with COPD, asthma and/or bronchiectasis. Of the total population, 9.6% were hospitalized due to exacerbations or ARIs, showing an incidence rate of 10.6 per 100 patient-years. Notably, patients with multiple respiratory diseases had hospitalization rates over 20%. Of the 24,186 hospitalizations, 6.5% necessitated intensive care, and 2.2% were fatal. Increased risk of hospitalization was associated with being 85 or older, having multiple respiratory conditions, and taking certain medications such as antipsychotics and anti-dementia drugs. This study reveals a notable rate of hospitalization due to exacerbations or ARIs among older adults with chronic respiratory diseases, with age, multiple conditions, and specific medications being major risk factors. The findings underscore the need for targeted preventive strategies and careful management of this vulnerable population.
慢性呼吸道疾病在老年人中的患病率不断上升，这对发病率和死亡率产生了重大影响。病情加重和急性呼吸道感染（ARI）导致的住院给医疗系统带来了沉重负担。本研究旨在估计全国范围内患有慢性呼吸道疾病的老年人因上述情况住院的发生率，识别风险因素，并评估诸如重症监护需求和死亡率等结局。利用国民健康保险服务高龄队列（2016 - 2017年）的数据，我们分析了60岁及以上被诊断患有慢性阻塞性肺疾病、哮喘或支气管扩张症的患者。我们追踪了两年内的住院率，采用Cox回归模型来识别住院的预测因素。在117,793名患者中，16,024名（13.6%）患者患有与慢性阻塞性肺疾病、哮喘和/或支气管扩张症重叠的呼吸道疾病。在总人口中，9.6%的人因病情加重或急性呼吸道感染而住院，发病率为每100患者年10.6例。值得注意的是，患有多种呼吸道疾病的患者住院率超过20%。在24,186例住院病例中，6.5%需要重症监护，2.2%是致命的。住院风险增加与年龄在85岁及以上、患有多种呼吸道疾病以及服用某些药物（如抗精神病药物和抗痴呆药物）有关。本研究揭示了患有慢性呼吸道疾病的老年人因病情加重或急性呼吸道感染而住院的显著比例，年龄、多种病情和特定药物是主要风险因素。研究结果强调了针对这一弱势群体制定有针对性的预防策略和进行谨慎管理的必要性。
